Romania - Functional Review : Health Sector
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Washington, DC
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This Functional Review was carried by a
Bank team upon request by the Government of Romania. As a
starting point, it shows that: (i) health outcomes in
Romania lag behind those of the EU; (ii) users are not
satisfied with its lack of responsiveness - long lines,
informal payments, discourteous handling of patients, poor
cleanliness, lack of maintenance, and breach of safety
measures; (iii) the poor and other vulnerable groups (for
example Roma communities) suffer from a significant lack of
access to services; and (iv) the fiscal contraction of
2008-2010 exposed the weakness of financial controls in the
health sector. The Review examines four health functions in
depth: service delivery, financing, stewardship and
resources (including pharmaceuticals). Based on our
findings, we present recommendations categorized by the
three set of challenges that the sector is facing: (i)
improving governance and management; (ii) streamlining the
health service network and re-launching quality control
systems; and (iii) increasing preventive services and
equity. For any expansion of the sector to be sustainable, a
number of pre-requisites will need to be in place, including
a private sector development strategy, stronger fiscal
controls, a system of health technology assessment, and
stronger management in key agencies.
Palabras clave
ACCESS TO HEALTH CARE, ACCESS TO HEALTH SERVICES, ACCESS TO SERVICES, AGE GROUPS, AGE STRUCTURE, AGING, AMBULATORY CARE, AMBULATORY SERVICES, BUDGET CEILING, BUDGET INCREASE, BURDEN OF DISEASE, CAPITATION, CARDIOVASCULAR DISEASES, CARE PURCHASERS, CENTER FOR HEALTH, CERVICAL CANCER, CHILD HEALTH, CHRONIC CONDITIONS, CHRONIC DISEASE, CITIZENS, CLEANLINESS, CLINICAL GUIDELINES, CLINICS, COMMUNICABLE DISEASES, CONTRACTUAL RELATIONS, CONTRACTUAL RELATIONSHIPS, CONTRIBUTION RATE, COST STRUCTURE, COST-EFFECTIVENESS, DAY CARE, DEATH RATE, DEATHS, DEBT, DECISION MAKING, DELIVERY OF HEALTH SERVICES, DEMOCRACY, DIABETES, DOCTORS, ECONOMIC GROWTH, EMERGENCIES, EQUITY IN ACCESS, EXPENDITURES, FAMILIES, FEES FOR SERVICE, FINANCIAL BARRIERS, FINANCIAL CONTROLS, FINANCIAL INCENTIVES, FINANCIAL INFORMATION, FINANCIAL MANAGEMENT, FINANCIAL PROTECTION, FINANCIAL RESOURCES, FINANCIAL RISK, FINANCING OF HEALTH CARE, GENERAL PRACTITIONERS, GROSS DOMESTIC PRODUCT, GROSS NATIONAL PRODUCT, HEALTH CARE INSTITUTIONS, HEALTH CARE NEEDS, HEALTH CARE PROVIDER, HEALTH CARE PROVIDERS, HEALTH CARE SYSTEM, HEALTH DATA, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH FINANCING, HEALTH FOR ALL, HEALTH INDICATORS, HEALTH INSURANCE, HEALTH INSURANCE CONTRIBUTIONS, HEALTH INSURANCE FUNDS, HEALTH INSURANCE SYSTEM, HEALTH MANAGEMENT, HEALTH MINISTRIES, HEALTH NEEDS, HEALTH ORGANIZATION, HEALTH OUTCOMES, HEALTH POLICIES, HEALTH POLICY, HEALTH PROFESSIONALS, HEALTH PROGRAMS, HEALTH PROMOTION, HEALTH PROVIDERS, HEALTH PURCHASER, HEALTH REFORM, HEALTH REFORMS, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE DELIVERY, HEALTH SERVICES, HEALTH SPENDING, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEM PERFORMANCE, HEALTH SYSTEMS, HEALTH WORKERS, HEALTH WORKFORCE, HIV, HIV/AIDS, HOLISTIC APPROACH, HOME CARE, HOSPITAL, HOSPITAL ACCREDITATION, HOSPITAL ADMINISTRATORS, HOSPITAL ADMISSIONS, HOSPITAL BEDS, HOSPITAL CARE, HOSPITAL PATIENTS, HOSPITAL SECTOR, HOSPITAL SERVICES, HOSPITALIZATION, HOSPITALS, HR, HUMAN IMMUNODEFICIENCY VIRUS, HUMAN RESOURCE MANAGEMENT, HUMAN RESOURCES, HYGIENE, HYPERTENSION, ILLNESS, IMMUNIZATION, IMMUNODEFICIENCY, INCENTIVES FOR PROVIDERS, INCOME, INCOME COUNTRIES, INCOME DISTRIBUTION, INCOME GROUPS, INFANT MORTALITY, INFANT MORTALITY RATES, INFECTIOUS DISEASES, INFORMAL PAYMENTS, INFORMAL SECTOR, INFORMATION SYSTEM, INFORMATION SYSTEMS, INTEGRATION, LIFE EXPECTANCY, LIFE EXPECTANCY AT BIRTH, LIVE BIRTHS, LOCAL GOVERNMENTS, LOW INCOME, MALARIA, MANAGEMENT OF HUMAN RESOURCES IN HEALTH, MATERNAL DEATHS, MATERNAL MORTALITY, MEDICAL CARE, MEDICAL DOCTORS, MEDICAL EQUIPMENT, MEDICAL SERVICES, MEDICAL SPECIALTIES, MEDICAL TECHNOLOGY, MEDICINES, MIGRATION, MINISTRY OF HEALTH, MORBIDITY, MORTALITY, NATIONAL HEALTH, NATIONAL HEALTH INSURANCE, NATIONAL HEALTH INSURANCE FUND, NATIONAL HEALTH POLICIES, NON-GOVERNMENTAL ORGANIZATIONS, NURSE, NURSING, NURSING HOMES, NUTRITION, OLD SYSTEM, OUTPATIENT SERVICES, PALLIATIVE CARE, PATIENT, PATIENT RIGHTS, PATIENTS, PHARMACEUTICAL EXPENDITURE, PHARMACIES, PHARMACY, PHYSICAL ACTIVITY, PHYSICIAN, PHYSICIANS, PLASTIC SURGERY, POLICY DOCUMENT, POLICY FORMULATION, PRESCRIPTION DRUGS, PRIMARY CARE, PRIMARY CARE DOCTORS, PRIMARY HEALTH CARE, PRIMARY HEALTH CARE SERVICES, PRIVATE FINANCING, PRIVATE INSURANCE, PRIVATE SECTOR, PRIVATE SERVICES, PROBABILITY, PROFESSIONAL ASSOCIATIONS, PROGRESS, PROVISION OF SERVICES, PUBLIC ADMINISTRATION, PUBLIC HEALTH, PUBLIC HOSPITALS, PUBLIC POLICIES, PUBLIC SECTOR, PUBLIC SPENDING, QUALITY CONTROL, QUALITY OF LIFE, RADIOLOGY, REHABILITATION, RESPECT, RISK FACTORS, SAFETY MEASURES, SCREENING, SERVICE PROVISION, SMOKING, SOCIAL HEALTH INSURANCE, SURGERY, TB CONTROL, TUBERCULOSIS, USE OF HEALTH SERVICES, VACCINATION, VACCINATIONS, VULNERABLE GROUPS, WORKERS, WORLD HEALTH ORGANIZATION